Medicare Certification

Federal Medicare pays for services in acute care and psychiatric hospitals that voluntarily seek certification and are approved by the Centers for Medicare & Medicaid Services (CMS). CMS contracts with the Department of Health to evaluate compliance with the federal regulations by periodically conducting on-site surveys in these hospitals.

Application for Federal Medicare Certification:

For state-licensed acute care and psychiatric hospitals interested in Medicare certification, complete the following steps:

  1. Contact the department's Certificate of Need Program at 360-236-2955 before applying for Medicare certification.
  2. Contact the department's Construction Review Services at 360-236-2944 prior to the start of construction for review and approval of construction documents.
  3. Once Certificate of Need and Construction Review Services approval is granted, submit the Medicare application (form 855A) to the Medicare Administrative Contractor (MAC).
  4. The MAC will review form 855A and, if approved, will send a copy of the approval to the Medicare Program in the Office of Investigations and Inspections and CMS.
  5. The Medicare Program in the Office of Investigations and Inspections will contact the applicant and request specific Medicare related forms to be completed.
  6. Submit the completed forms to the Medicare Program in the Office of Investigation and Inspection.
  7. Upon receipt of the MAC recommendation letter the facility should arrange to have an Accrediting Organization (AO) do their initial survey.
  8. Once AO conducts the survey and submits results to the facility, facility should forward survey recommendation and findings to the Washington State Department of Health.
  9. Upon receipt of the survey and AO recommendation letter the Department completes and sends all Certification documentation including survey findings, 855A and required additional documentation with the states recommendation to CMS.
  10. Once CMS receives packet and completes there review, CMS will notify applicant of approval or denial.